More Older Americans Living With HIV

November 15, 2010

Better treatments are extending the lives of people with HIV, but aging with the AIDS-causing virus takes a toll that will challenge the health care system, a new report says.

A survey of about 1,000 HIV-positive men and women ages 50 and older living in New York City found more than half had symptoms of depression, a much higher rate than others their age without HIV.

And 91 percent also had other chronic medical conditions, such as arthritis (31 percent), hepatitis (31 percent), neuropathy (30 percent) and high blood pressure (27 percent). About 77 percent had two or more other conditions. About half had progressed to AIDS before they got the HIV diagnosis, the report found.

"The good news is antiretroviral therapies are working and people are living. If all goes well, they will have life expectancies similar to those without HIV," said Daniel Tietz, executive director of the AIDS Community Research Initiative of America.

"But a 55-year-old with HIV tends to look like a 70-year-old without HIV in terms of the other conditions they need treatment for," he said Wednesday at a meeting of the Office of National AIDS Policy at the White House in Washington, D.C.

The research included interviews with 640 men, 264 women and 10 transgender people. Dozens of experts on HIV and aging attended the meeting, which was intended to identify the needs of older adults with HIV and to explore ways to improve services to them.

Currently, about 27 percent of those with HIV are over 50. By 2015, more than half will be, said the report.

Because of their special needs, this poses challenges for public health systems and organizations that serve seniors and people with HIV, Tietz said.

HIV can be isolating, Tietz said. Seventy percent of older Americans with HIV live alone, more than twice the rate of others their age, while about 15 percent live with a partner, according to the report.

The survey found that loneliness was higher among HIV-positive adults than for other older Americans. One reason is that many men and women conceal the condition from friends and family for fear of stigma or rejection, both real and imagined, Tietz said.

Lack of social and family support increases the likelihood of needing costly health care, such as home health aides and nursing homes as they get older, Tietz said.

Dr. Amy Justice, an HIV researcher who also attended the meeting, spoke of the need for health care professionals to learn about specific issues facing HIV-positive seniors.

HIV organizations tend to gear messages toward younger people, and senior services organizations often don't know much about the needs of HIV-positive seniors, said Justice, principal investigator of the Veterans Aging Cohort Study. This ongoing study involves some 40,000 veterans with HIV and 80,000 without HIV from 10 Veterans Affairs medical centers nationwide.

"There are a lot of people with HIV who are 60 or 65 and even 80 or 85," Justice said. "Those individuals feel older than their stated age and may have some of the same problems people 10 or 15 years older would normally experience."

Many older Americans with HIV are still sexually active and should be encouraged to practice safe sex, Justice said. While 57 percent of older Americans with HIV said they disclosed their HIV status to sexual partners, about 16 percent didn't, the report found.

About half the survey participants were black, one-third were Hispanic and 14 percent were white. About 67 percent considered themselves heterosexual, 24 percent were gay and 9 percent bisexual.

Why people with HIV are more likely to have other chronic diseases is still unclear, Tietz said. The cause could be the HIV itself or long-term side effects from taking multiple medications, he said. Early HIV drugs were especially toxic, he added.